Years ago, dentists, lawyers, doctors and other professionals did not advertise. Adding a new professional to the practice or moving the office presented one of the few permissible opportunities to let the public know that services were available.

Lance Plunkett, general counsel for The Dental Society of the State of New York, said that today's relative openness dates from results of court cases in the late '70s.

"Then, a lot of the prohibitions on advertising came under attack under freedom of speech," Plunkett said.

Not only does the Dental Society have its code of ethics, which gives guidelines to it members, but the state maintains rules of professional conduct, which parallel the society's code.

"Some people feel that it is a free market and if advertising is regulated, the regulation should be from a scientific point of view. Statements in ads should be able to be verified scientifically, and the prohibition would be against making any claim you could not substantiate," he said.

The society prefers advertising that is helpful in educating the consumer about dentistry. A focal group told the society it wanted such information as descriptions of dental processes.

Dr. Robert Santoro is owner and president of Rose Dental Associates, a dental practice that moved recently to 5 West Pine Plaza on Washington Avenue Extension in Albany from Westgate Plaza. Santoro is a dentist who is deliberate about marketing.

"As with any business, the best marketing is your clients’ word of mouth," he said. "Word of mouth helps us a tremendous amount."

Referring to the Rose Dental newsletter, he said, "We send out the newsletter to encourage our patients of record to use us. We want to work more with the business we have and stimulate more business." Santoro added that he hopes the newsletter prompts patients to generate referrals among their family and friends who need dental services.

Rose Dental does not rely solely on the newsletter and has used direct mail and television ads to attract new patients. He said that participation in community events did not expose his group to a large number of people.

Although Santoro said that direct-mail marketing appears to be the most economical and successful, Rose Dental also uses the local TV channels because they not only are more economical than networks, but also more site-specific.

He said the thrust of Rose's marketing is "trying for name recognition."

"In our business, name recognition is very important if someone is to think of you as the need arises," he said. Santoro used the examples of beer and soft drink advertising, which helps the words Coke or Budweiser to enter your mind at the right moment. "Sometimes, it is the only thing that pops into your head. Hopefully, when a tooth breaks or they need another service, they will think of us."

He said that being a large organization has distinct advantages, noting that most dental practices are made up of one or two principals. "If they allocate 10 percent and I allocate 10 percent, we able to accomplish a lot more," Santoro said. Currently, Rose Dental has eight dentists and about 45 employees overall.

"Ten years ago, it was very provincial, but since then, health-care marketing has become a significant portion of marketing dollars and, as a result, people feel differently," he said. One reason for the change was the desire to allow competition to keep the cost of health care low.

Santoro said that now dentists are working on "relationship marketing," concerned with the effective needs and responses of their patients. He pointed out that even when tempted to leave by changes in dental coverage of insurance plans, many patients prefer to stay with his group.

Dr. Stuart Fass has a dental practice in Altamont with Dr. Adam Edwards. As one way to make the public aware of their services, they insert a short, paid article on dental topics in the Altamont Enterprise every week.

"I have always had a strong sense that informational advertising was the thing to do," Fass said. "We are in the service business, and the service ought to sell itself.

"We have been running that ad for going on 14 years," he said. "We deal with the service that supplies sample articles every quarter, and we [dentists] go through them and throw out the ones that don't apply to our practice, and add items on subjects they want to discuss.

"The Altamont Enterprise is not your typical pennysaver," Fass said, adding that it is quite common for new patients to say they have been reading the dental items for a number of years before coming into the office.

Acknowledging that the state Dental Society encourages members to emphasize advertising that informs, Fass said, "We were doing this long before the society's guidelines. We began as soon as it was legal."

Under the old code, it was by and large against the law to advertise in New York, except to say: "We are pleased to announce a new member," he said. Even that kind of public notice was limited, as were the size and number of signs at the dental practice.

"It was clearly a simple restraint of trade," he said, adding that changes were fueled by advances in dentistry in the late 1970s. As soon as he could, Fass said he began to advertise, simply stating his name, location and hours.

His practice also conducts school programs and takes space in community school yearbooks and programs to keep its name in front of the public.

"Advertising is a tool--it can be used or misused," Fass said. Recently, the two Altamont dentists began to rethink their annual holiday cards. By not sending commercial cards to their patients, and substituting a card generated in the office on computer, they were able to accumulate savings "in four figures," and donated the savings to area food pantries.

State education law prohibits certain kinds of advertising by health professionals. This includes not only advertising that is false or misleading but also that which guarantees a service, makes unfounded claims of superiority, or offers a bonus or inducement other than a reduction in a customary charge.

The law further delineates what forms of advertising are "appropriate." Among those permitted is the use of testimonials, as long as several qualifying conditions are met.

The state Dental Society, however, sees things differently. It encourages advertising by concluding that advertising "shall not be considered unethical or improper, except for those promotional activities which are false or misleading in any material respect."

In the advisory statements that accompany its code of ethics, the society states, "Advertising that uses testimonials or guarantees is unethical because it is inherently misleading."

Also declared inappropriate by the group are ads that do not include the range of fees and ones that use honorary or non-health-related degrees, or mention discounts or free services without acknowledging the usual cost.

The NYNEX telephone books offer coupons for car repair, tax preparation services and, now, dental services. The coupons can be turned in for dental practice discounts such as reduction in the cost of certain services, free X-rays--if needed--and complimentary exams and cleaning for new customers.

R.J. Adolfi manages a chain of dental practices with more than 70 dentists. These include UpState Dental Health Services P.C. in Northway Mall in Colonie. His ads in the NYNEX coupon section focus specifically on dentures and services to older clients. UpState offers a 15 percent discount on the cost of new dentures and exams.

According to Adolfi's statistics, about 70 percent of the chain's new patients are referrals, and the remaining 30 percent have responded to ads.

"We take the approach that if you take care of your referrals, if you follow through and are inexpensive, the business will come," he said. Advertising gets the flow started and keeps new people coming in every week, Adolfi said.

Unaffiliated with health maintenance organizations, he perceives his client base to be blue-color workers who pay cash for dental services and are demanding quality and price.

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